MR-derived renal morphology and renal function in patients with atherosclerotic renovascular disease
MR-derived renal morphology and renal function in patients with atherosclerotic renovascular disease
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DOI：
10.1038/sj.ki.5000118
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发表时间：
2006-02-01
影响因子：
19.6
通讯作者：
Kalra, PA
中科院分区：
文献类型：
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作者：
Cheung, CM;Shurrab, AE;Kalra, PA
如果使用准确的非侵入性检查来评估先前存在的实质损伤的严重程度，则可能会改善对动脉粥样硬化性肾血管疾病（ARVD）患者进行血运重建的适当选择。本研究的目的是评估 ARVD 中磁共振成像 (MRI) 测量的肾脏形态参数与单肾肾小球滤过率 (GFR) 之间的关联。对 35 名 ARVD 患者进行了三维 (3D)-MRI。测量了 65 个肾脏的肾双极长度 (BL)、实质体积、实质 (PT) 和皮质厚度 (CT)。 13 个肾脏由正常血管供血，13 个肾脏有轻微（< 50%）肾动脉狭窄（RAS），33 个肾脏有显着（>= 50%）肾动脉狭窄，6 个肾脏完全血管闭塞。所有患者均接受单肾 GFR（isoSK-GFR）的放射性同位素测量。总体而言，3D 参数（例如实质体积）与 isoSK-GFR（r = 0.86，P < 0.001）的相关性优于 BL（r = 0.78，P < 0.001）、PT（r = 0.63，P < 0.001）或 CT（r = 0.60，P < 0.001）。与正常血管供应的肾脏相比，RAS >= 50% 的肾脏确实表现出平均 CT 显着降低（5.67 +/- 1.63 vs 7.28 +/- 1.80mm，P = 0.002；减少 22.1%），并且实质体积损失更大（120.65 +/- 47.15 vs 179.24 +/- 86.90ml，P < 0.001；减少 32.7%），BL 没有显着减少。在 >= 50% RAS 肾脏的比例中，观察到与 isoSK-GFR 不成比例的高实质体积，支持“冬眠实质”的概念。与 BL、PT 或 CT 的二维测量相比，实质体积的 3D 参数与 isoSK-GFR 的相关性更强。 3D 形态学评估与 isoSK-GFR 结合可能有助于帮助患者选择肾血运重建。 SK-GFR 实质体积增加的肾脏可能代表一个可能对血管成形术产生有益反应的亚组。
Appropriate selection of patients with atherosclerotic renovascular disease ( ARVD) for revascularization might be improved if accurate non-invasive investigations were used to assess severity of pre-existing parenchymal damage. The purpose of this study was to evaluate the associations between magnetic resonance imaging ( MRI)-measured renal morphological parameters and single-kidney glomerular filtration rate ( GFR) in ARVD. Three-dimensional ( 3D)-MRI was performed on 35 ARVD patients. Renal bipolar length ( BL), parenchymal volume, parenchymal ( PT), and cortical thicknesses ( CT) were measured in 65 kidneys. Thirteen kidneys were supplied by normal vessels, 13 had insignificant ( < 50%) renal artery stenosis ( RAS), 33 significant ( >= 50%) RAS, and six complete vessel occlusion. All patients underwent radioisotopic measurement of single-kidney GFR ( isoSK-GFR). Overall, 3D parameters such as parenchymal volume were better correlates of isoSK-GFR ( r = 0.86, P < 0.001) than BL ( r = 0.78, P < 0.001), PT ( r = 0.63, P < 0.001) or CT ( r = 0.60, P < 0.001). Kidneys with >= 50% RAS did show significant reduction in mean CT compared to those supplied by normal vessel ( 5.67 +/- 1.63 vs 7.28 +/- 1.80mm, P = 0.002; 22.1% reduction) and an even greater loss of parenchymal volume ( 120.65 +/- 47.15 vs 179.24 +/- 86.90ml, P < 0.001; 32.7% reduction) with no significant reduction in BL. In a proportion of >= 50% RAS kidneys, a disproportionately high parenchymal volume to isoSK-GFR was observed supporting a concept of 'hibernating parenchyma'. 3D parameters of parenchymal volume are stronger correlates of isoSK-GFR than two-dimensional measures of BL, PT or CT. 3D morphological evaluation together with isoSK-GFR might be useful in aiding patient selection for renal revascularization. Kidneys with increased parenchymal volume to SK-GFR might represent a subgroup with the potential to respond beneficially to angioplasty.